Friday, March 20, 2009

But not yet, Lord

Mar 19th 2009 | NEW YORKFrom The Economist print edition

Religious people seem curiously reluctant to meet their maker

HOW do a person’s religious beliefs influence his attitude to terminal illness? The answer is surprising. You might expect the religious to accept death as God’s will and, while not hurrying towards it, not to seek to prolong their lives using heroic and often traumatic medical procedures. Atheists, by contrast, have nothing to look forward to after death, so they might be expected to cling to life.

In fact, it is the other way round—at least according to a study published in the Journal of the American Medical Association by Andrea Phelps and her colleagues at the Dana-Farber Cancer Institute in Boston. Religious people seem to use their faith to cope with the pain and degradation that “aggressive” medical treatment entails, even though such treatment rarely makes much odds.

Dr Phelps and her team followed the last months of 345 cancer patients. The participants were not asked directly how religious they were but, rather, about how they used any religious belief they had to cope with difficult situations by, for example, “seeking God’s love and care”. The score from this questionnaire was compared with their requests for such things as the use of mechanical ventilation to keep them alive and resuscitation to bring them back from the dead.

The correlation was strong. More than 11% of those with the highest scores underwent mechanical ventilation; less than 4% of those with the lowest did so. For resuscitation the figures were 7% and 2%.

Explaining the unpleasantness and futility of the procedures does not seem to make much difference, either. Holly Prigerson, one of Dr Phelps’s co-authors, was involved in another study at Dana-Farber which was published earlier this month in the Archives of Internal Medicine. This showed that when doctors had frank conversations about the end of life with terminally ill cancer patients, the patients typically chose not to request very intensive medical interventions.

According to Dr Prigerson, though, such end-of-life chats had little impact on “religious copers”, most of whom still wanted doctors to make every effort to keep them alive. Saint Augustine of Hippo, one of Christianity’s most revered figures, famously asked God to help him achieve “chastity and continence, but not yet”. When it comes to meeting their maker, many religious people seem to have a similar attitude.